Med Spa Quote Form Template — Screen, Price and Book the Treatment
A treatment price plus area, package and preparation fees, with a screening step that routes unsuitable enquiries to a consultation instead of a checkout.
Overview
Aesthetic medicine sells outcomes, and clients shop by treatment name: a chemical peel, laser hair removal, a signature facial. They already know roughly what the treatment costs, so the quote that wins is the one that answers "what exactly will I need, and when can I be seen?"
The form also has a job a price list cannot do: screen the client. Pregnancy, a recent treatment or a medical history note must send the enquiry to a consultation rather than a checkout button. The template builds that branch into the form instead of leaving it to a phone call.
Best for
Med spas and aesthetic clinics that publish starting prices but must screen a client before a treatment, and that sell packages of three and six sessions.
The field list
Every question below earns its place: it changes the price, the visit or the crew. If a question does none of the three, leave it out.
| Field | Type | Why it is asked |
|---|---|---|
| Treatment area | Select (single) | Face, neck, underarms, legs or body. The area is the first thing that changes both the price and the session length. |
| Primary concern | Select (single) | Texture, pigmentation, hair reduction or laxity. It lets the form recommend a treatment instead of listing all of them. |
| Treatment package | Select (single) | A single session, three sessions or six. Packages carry their own discount and must be priced as a unit. |
| First visit? | Yes / No | A first visit needs a consultation and a patch test; a returning client can book the treatment directly. |
| Skin type | Select (single) | Fitzpatrick type I–VI decides which laser and peel settings are appropriate, and whether a test is required. |
| Medical history flag | Yes / No | A single screening question that catches the answers that must be discussed before any treatment is quoted. |
| Pregnant or breastfeeding? | Yes / No | Rules out several treatments entirely. Asking here prevents a booking that would have to be cancelled. |
| Previous aesthetic treatments | Text (optional) | Recent fillers, peels or laser change the safe interval and sometimes the price. |
| Consultation required | Yes / No | The practitioner can require a consultation even when the screening answers are clean. |
| Preferred practitioner | Select (single) | Clients often choose the person, not the clinic. Their price and availability belong in the quote. |
| Patch test needed? | Yes / No | A patch test is a separate appointment with its own fee and its own lead time before the treatment. |
| Treatment area size | Select (single) | Small, medium or large. Laser pricing depends on the area size far more than on the treatment name. |
Price rules
Each row is one option in the builder with the operation attached to it. The example column is the arithmetic you should see in the live total; use it to check your own configuration before publishing.
| Option | Rule | Worked example |
|---|---|---|
| Signature facial | +95 | 95 |
| Chemical peel | +140 | 140 |
| Anti-wrinkle consultation | +60 | 60 |
| Laser hair removal (small area) | +110 | 110 |
| Laser hair removal (large area) | +240 | 240 |
| Body contouring session | +180 | 180 |
| Package of three sessions | −10% | 3 × 140 = 420 → 378 |
| Package of six sessions | −18% | 6 × 140 = 840 → 688.80 |
| Patch test | +25 | 25 |
| Consultation fee (redeemed against treatment) | +40 | 40, deducted from the treatment price when booked |
| Anaesthetic cream | +30 | 30 |
| Extended area surcharge | +20 | 20 |
The amounts are illustrative, not a price list. Replace them with your own cost base and currency before publishing — and keep the order of the rules, because a percentage applied to the wrong subtotal changes every total downstream.
Conditional logic
Conditional rules keep the form short without losing the information. Add them in the order below and test each trigger before you publish.
If Pregnant or breastfeeding is Yes
Then Hide the peel and laser options and show a consultation-only message. Those treatments are not offered during pregnancy.
If First visit is Yes
Then Require the consultation and add the patch test if a laser treatment is chosen.
If Treatment package includes laser
Then Require the patch test question and explain the lead time before the first session.
If Medical history flag is Yes
Then Replace the instant quote with "book a consultation". A history answer must be read by the practitioner.
If Treatment area size is Large
Then Apply the extended area surcharge and move to the large-area laser price instead of the small-area one.
If Consultation required is Yes
Then Show the consultation fee with the note that it is deducted from the treatment when booked.
Rebuild it in Clickobook
This is the build order we use. It ends with two test submissions, because a priced form is only correct when a total you calculated by hand matches the one on screen.
-
1
Create a "Your treatment" section with treatment area, primary concern and package size. Let the concern narrow the treatment list before the client sees the prices.
-
2
Add the screening questions — first visit, skin type, medical history flag and pregnancy — and place them BEFORE the price is revealed. A price shown to a client who cannot be treated is a cancelled booking.
-
3
Price the treatments as single sessions, then add the three- and six-session package rules as percentage discounts on the chosen treatment. Never discount the patch test or the consultation fee.
-
4
Add the preparation add-ons: patch test, anaesthetic cream and the extended-area surcharge.
-
5
Add the conditional rules and test three paths: a returning laser client, a first-visit peel, and a pregnant enquiry. The third must never reach a checkout.
-
6
Connect the consultation and patch-test options to real appointment slots so a screening appointment is booked, not just requested.
Three things that make this template convert
Show the consultation fee as redeemable, not free. A redeemable fee filters serious enquiries and still feels fair.
Keep the medical screening questions short and plain. The form is not a medical record, and a long questionnaire loses the client before the price.
Price the patch test separately. Folding it into the treatment hides a real appointment and a real cost.
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Start from this template
Create the form, add your own rates and publish it on your booking page — then take the deposit when the visitor books the slot.